Editorial Advances in Biliary Tract Disorders: Novel...
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Editorial Advances in Biliary Tract Disorders: Novel Biomarkers, Pharmacotherapies, Endoscopic Techniques, and Surgical Management Mohamad H. Imam, 1 Sooraj Tejaswi, 2 Mohammed Nabil Quraishi, 3 and James H. Tabibian 2 1 Division of Gastroenterology and Hepatology, University of Tennessee Health and Science Center, Memphis, TN, USA 2 Division of Gastroenterology and Hepatology, University of California, Davis, Sacramento, CA, USA 3 Department of Gastroenterology, University Hospital Birmingham, Birmingham, UK Correspondence should be addressed to James H. Tabibian; [email protected] Received 9 November 2016; Accepted 9 November 2016 Copyright © 2016 Mohamad H. Imam et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Biliary tract disorders encompass a wide range of benign and malignant disease processes. In this special issue, we aimed to highlight advances in novel biomarkers, pharmacotherapies, endoscopic techniques, and surgical management of a variety of biliary tract disorders. Such advances continue to lead to improved diagnostic accuracy, better therapies, and subse- quently superior patient outcomes. Manuscripts selected for publication in this issue come from around the world and address clinically relevant topics and advances in biliary tract disorders, as briefly summarized below. Endoscopic retrograde cholangiopancreatography (ERCP) is an established procedure with numerous applications in biliary tract disorders. However, it may be associated with several periprocedural complications, including acute pan- creatitis and cholangitis. e presence of periampullary diverticula (PAD) may influence the technical success and safety of ERCP and hence affect patient outcomes. Z. Sun et al. evaluate the difference in clinical outcomes between 161 patients with PAD as compared to matched controls. Technical modifications and ancillary techniques to ERCP are areas of ongoing research. A strategy that involves placement of a biliary stent to avoid sphincterotomy in patients undergoing ERCP for common bile duct stones is described by T. Ueda et al.; preserving papillary integrity via such a technique may be especially desirable in younger patients. e use of endoscopic ultrasound (EUS) guided bil- iary drainage as an alternative treatment for biliary obstruc- tion in cases of failed ERCP is growingly implemented; J. Guo et al. describe the outcomes of their experience utilizing this approach for the management of biliary obstruction. T. A. P. Franzini et al. provide an overview of various cholangioscopy techniques and comment on recent advances in visualization of the biliary system and its application to biliary disease management. Evolution of specific surgical techniques such as those employed in Roux-en-Y hepaticojejunostomy is reviewed from a technical standpoint by D. Moris et al. ey sum- marize their 25-year experience with RYHJ for management of bile duct injury and different perioperative measures they implement to optimize patient outcomes. Various malignancies have been associated with primary biliary diseases. Optimization of surveillance strategies and care for these patients is crucial. A review manuscript by V. Hrad et al. summarizes the cancer risks found in different pri- mary biliary diseases, including primary sclerosing cholangi- tis, primary biliary cholangitis, and overlap syndrome. is is complemented by a review paper in which L. Z. C. T. Pu et al. discuss evidence for best practice in management of malignant biliary strictures. For unresectable intrahepatic cholangiocarcinoma, treatment options are limited and oſten disappointing. R. Seidensticker et al. aim to assess the outcomes of patients with unresectable intrahepatic cholangiocarcinoma treated by a tailored therapeutic approach, combining sys- temic and advanced image-guided local or locoregional therapies. Hindawi Publishing Corporation Gastroenterology Research and Practice Volume 2016, Article ID 1583486, 2 pages http://dx.doi.org/10.1155/2016/1583486
Transcript of Editorial Advances in Biliary Tract Disorders: Novel...
EditorialAdvances in Biliary Tract Disorders:Novel Biomarkers, Pharmacotherapies, EndoscopicTechniques, and Surgical Management
Mohamad H. Imam,1 Sooraj Tejaswi,2
Mohammed Nabil Quraishi,3 and James H. Tabibian2
1Division of Gastroenterology and Hepatology, University of Tennessee Health and Science Center, Memphis, TN, USA2Division of Gastroenterology and Hepatology, University of California, Davis, Sacramento, CA, USA3Department of Gastroenterology, University Hospital Birmingham, Birmingham, UK
Correspondence should be addressed to James H. Tabibian; [email protected]
Received 9 November 2016; Accepted 9 November 2016
Copyright © 2016 Mohamad H. Imam et al. This is an open access article distributed under the Creative Commons AttributionLicense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properlycited.
Biliary tract disorders encompass a wide range of benign andmalignant disease processes. In this special issue, we aimed tohighlight advances in novel biomarkers, pharmacotherapies,endoscopic techniques, and surgical management of a varietyof biliary tract disorders. Such advances continue to lead toimproved diagnostic accuracy, better therapies, and subse-quently superior patient outcomes. Manuscripts selected forpublication in this issue come from around the world andaddress clinically relevant topics and advances in biliary tractdisorders, as briefly summarized below.
Endoscopic retrograde cholangiopancreatography (ERCP)is an established procedure with numerous applications inbiliary tract disorders. However, it may be associated withseveral periprocedural complications, including acute pan-creatitis and cholangitis. The presence of periampullarydiverticula (PAD) may influence the technical success andsafety of ERCP and hence affect patient outcomes. Z. Sun etal. evaluate the difference in clinical outcomes between 161patients with PAD as compared to matched controls.
Technical modifications and ancillary techniques toERCP are areas of ongoing research. A strategy that involvesplacement of a biliary stent to avoid sphincterotomy inpatients undergoing ERCP for common bile duct stones isdescribed by T. Ueda et al.; preserving papillary integrityvia such a technique may be especially desirable in youngerpatients.The use of endoscopic ultrasound (EUS) guided bil-iary drainage as an alternative treatment for biliary obstruc-tion in cases of failed ERCP is growingly implemented; J. Guo
et al. describe the outcomes of their experience utilizing thisapproach for the management of biliary obstruction. T. A. P.Franzini et al. provide an overview of various cholangioscopytechniques and comment on recent advances in visualizationof the biliary system and its application to biliary diseasemanagement.
Evolution of specific surgical techniques such as thoseemployed in Roux-en-Y hepaticojejunostomy is reviewedfrom a technical standpoint by D. Moris et al. They sum-marize their 25-year experience with RYHJ for managementof bile duct injury and different perioperative measures theyimplement to optimize patient outcomes.
Various malignancies have been associated with primarybiliary diseases. Optimization of surveillance strategies andcare for these patients is crucial. A review manuscript by V.Hrad et al. summarizes the cancer risks found in different pri-mary biliary diseases, including primary sclerosing cholangi-tis, primary biliary cholangitis, and overlap syndrome. Thisis complemented by a review paper in which L. Z. C. T.Pu et al. discuss evidence for best practice in managementof malignant biliary strictures. For unresectable intrahepaticcholangiocarcinoma, treatment options are limited and oftendisappointing.
R. Seidensticker et al. aim to assess the outcomes ofpatients with unresectable intrahepatic cholangiocarcinomatreated by a tailored therapeutic approach, combining sys-temic and advanced image-guided local or locoregionaltherapies.
Hindawi Publishing CorporationGastroenterology Research and PracticeVolume 2016, Article ID 1583486, 2 pageshttp://dx.doi.org/10.1155/2016/1583486
2 Gastroenterology Research and Practice
Lastly, gallstone disease remains a major public healthburden worldwide. A. Hayasaki et al. aim to identify signifi-cant independent variables influencing postoperative hospi-tal stay andmedical costs in patients with definite, suspected,or unmatched acute cholecystitis diagnosis according to the2013 Tokyo Guidelines.
We hope the manuscripts in this special issue will high-light useful advances in the field and help lay groundwork forfurther studies addressing the etiopathogenesis, diagnosis,and management of biliary tract disorders.
Mohamad H. ImamSooraj Tejaswi
Mohammed Nabil QuraishiJames H. Tabibian
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